This invention relates generally to processing diagnostic image datasets, and more particularly, to predicting a functional impact of, and evaluating a vulnerability of, an occlusion within a vessel.
Cardiovascular related deaths constitute more than 500,000 people annually in the USA, and much more globally. A major portion of the deaths are attributed to coronary artery disease, where the chief culprit is the build up of plaque, such as soft plaque and its ruptures, as well as hard plaque or calcification.
Typically in x-ray or non-contrasted CT studies, soft plaque is not easily detectable. Calcified plaque, therefore, has been used as a surrogate for the presence of soft plaque, based on the reasoning that calcified plaque is the by-product of ruptured plaque. Coronary plaque has been classified into six stages according to the Stary scale. According to general consensus, it is crucial to determine the plaque in stages 4 and 5 as the plaque constitutes critical vulnerable plaque and could lead to rupture or dislodging of the plaque, causing blockages and leading to myocardial infarction. Plaque and its constituency may be determined by IntraVascular Ultrasound (IVUS). However, the procedure is only performed on symptomatic patients due to its invasive nature. Unfortunately, symptomatic patients are already at an advanced stage and past non-invasive therapy options.
Newer scanning technologies, such as Volume Computed Tomography (VCT), along with associated increases in spatial and temporal resolution, have made it possible to image a contrasted study of the heart which is gated to mitigate heart motion. Using these images, it is possible to distinguish soft plaque from lumen (the vessel wall) and from calcification. However, automated methods do not exist and thus standardization and productivity suffer due to the volume of data to be reviewed and manually processed.
Once a lesion or deposit is identified, a treatment plan may be determined for the patient. No single source exists for providing predictive data based on verified patient case reports, and there is currently no method for automatically predicting the impact of a particular lesion on a particular patient's anatomy. Instead, the extent of the functional impact of an occlusion is typically determined after the occlusion has occurred, such as with a SPECT scan.
Manually analyzing the image datasets is time consuming and prone to error. Also, few care givers have time to spend analyzing substantial amounts of literature to find predictive information corresponding to the specific lesion location of the patient. As a result, the recommendations for care may be influenced by a variety of other factors, such as experience of the care giver, case load, availability of equipment, reimbursement for care, and the like. This may lead to inconsistencies and missed opportunities for utilizing non-invasive therapy options.
Therefore, a need exists for evaluating potential occlusions within a vessel to determine potential functional impact. Certain embodiments of the present invention are intended to meet these needs and other objectives that will become apparent from the description and drawings set forth below.